Individual provider Active NPI

Shavon Davis, NP

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1992479042
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277005792 Issued in IL
Practice address
2231 E 95TH St
Chicago, IL 60617-4804
Phone
(773) 768-7700
Fax
(773) 273-8915
NPI assigned
Aug 3, 2021
Last updated
Aug 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 277005792 IL Primary

Addresses

Primary practice location

2231 E 95TH St
Chicago, IL 60617-4804

Mailing address

2231 E 95TH St
Chicago, IL 60617-4804
Phone (773) 768-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210907002429 IN Practitioner - Nurse Practitioner 6709282387 Reassigns benefits to 1 organization
I20241120003412 IL Practitioner - Nurse Practitioner 6709282387 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Urgent Care Professionals PLLCGroup PAC ID 9830437946, 36 clinicians
PMR Illinois Holding LLCGroup PAC ID 2062804909, 10 clinicians

Practice addresses (Care Compare)

17960 Halsted St
Homewood, IL 60430-2014
Phone (708) 922-0911

2231 E 95TH St
Chicago, IL 60617-4804
Phone (773) 768-7700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
277005792ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jencare Neighborhood Medical Center South Chicago, LLC CurrentSince Nov 17, 2024 Accepting new patients
Illinois Urgent Care Professionals PLLC CurrentSince Jan 7, 2026 Accepting new patients
PMR Illinois Holding, LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

10834B S Doty Ave
Chicago, IL 60628
Phone (773) 995-9911

2231 E 95th St
Chicago, IL 60617
Phone (773) 768-7700

2734 W 87th St
Chicago, IL 60652
Phone (773) 918-4700

7444 W Wilson Ave
Ste 102
Harwood Hts, IL 60706
Phone 2249996997101

17960 Halsted St
Homewood, IL 60430
Phone (708) 923-0911

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1992479042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2231 E 95TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174804",
            "telephone_number": "773-768-7700",
            "fax_number": "773-273-8915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 E 95TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174804",
            "telephone_number": "773-768-7700",
            "fax_number": "773-273-8915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SHAVON",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277005792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.